Scott A. Schwartz

Clinical Outcomes of Artificial Root-end Barriers with Mineral Trioxide Aggregate in Teeth with Immature Apices

The purpose of this retrospective study was to evaluate the clinical outcomes of ProRoot mineral trioxide aggregate used as an artificial apical barrier in teeth with immature apices. Twenty teeth from 19 patients were included in this study. A healed diagnosis was based on periapical index scores of 1 or 2 and no clinical signs or symptoms at recall examinations. Eighty-five percent (17/20) of these teeth were healed, and improvements in periapical index scores at recall appointments were shown to be statistically significant (P < .001, Wilcoxon signed-rank test). Chi-square test indicated that age, gender, primary treatment versus retreatment, presence of preoperative lesion, and differences in recall times did not significantly influence healing outcome. Overall, these results indicated that the mineral trioxide aggregate apical barrier technique is a successful method for obturating teeth with immature apices.

A Retrospective Study Comparing Clinical Outcomes after Obturation with Resilon/Epiphany or Gutta-Percha/Kerr Sealer

The purpose of this retrospective study was to evaluate the treatment outcome of root canal systems obturated with gutta-percha and Kerr Pulp Canal Sealer compared with Resilon and Epiphany sealer. One hundred three teeth treated in a private endodontic practice were included in the study. Clinical outcomes (healed versus nonhealed) were assessed by using the Periapical Index determination and clinical evaluation at recall appointments. The magnitude of the association between obturation materials used and outcome measured was evaluated with univariate and multivariate logistic regression analysis. Univariate analysis indicated that pulpal vitality, presence of a preoperative lesion, and length of recall times were statistically significant in predicting the outcome. Logistic regression analysis showed that age, tooth position, and length of recall times were statistically significant in predicting the outcome. Root canal systems obturated with gutta-percha and Kerr Pulp Canal Sealer or Resilon and Epiphany sealer had statistically indistinguishable differences in clinical outcome.

A comparison of leakage between silver-glass ionomer cement and amalgam retrofillings

Apical microleakage following reverse filling with zinc-free amalgam was compared with that using silver-glass ionomer cement. The root canals of 20 extracted human maxillary canine teeth were instrumented and obturated with laterally condensed gutta-percha and sealer. Each root was then apically resected at a 45-degree angle to the long axis of the tooth. Following application of nail polish to the root surfaces, standardized apical cavity preparations were made. Ten of the cavity preparations were coated with cavity varnish and filled with zinc-free amalgam; the other 10 preparations were filled with silver-glas ionomer cement. After retrofilling, specimens were suspended in 2% methylene blue dye and placed into an incubator at a temperature of 37°C for 7 days. The teeth were sectioned longitudinally, and the depth of linear dye penetration was measured. Penetration of dye was significantly less (p

Diagnostic Terminology: Report of an Online Survey

INTRODUCTION Diagnostic terminology used in endodontics has been based on historical use, textbook and glossary terms, best-available science, and personal conviction. There is minimal evidence that establishes an absolute set of terms that can be used to make a definitive diagnosis. As a component of the Consensus Conference on Diagnostic Terminology held in October 2008, an online survey was conducted to invitees to assess their opinions on diagnosis. METHODS Thirty-six questions were developed by the oversight committee and chairs of the subcommittees. Most questions used a modified Likert scale to generate a response. At least a 51% agreement or disagreement to the statement was considered a consensus, and a response greater than 25% but less than 51% generated a minority report. RESULTS Thirty-one of the 36 questions were designed to determine consensus. All 31 generated a consensus response, with 14 of those generating a minority report. Minority reports suggest that there was still greater than 25% of the respondents who did not follow consensus. Possible explanations were provided for those statements that generated a minority report. CONCLUSIONS Data from the online survey provided trends and preferences toward particular diagnostic terms and beliefs. The limitations of such a survey are multiple including the limited size and nature of the respondent group, responses based on opinion, and question design. The online survey results suggest an awareness for the specialty to develop better diagnostic tools and terminology that are biologically and metric based.

Apical closure in the presence of pulpal necrosis: Report of two cases*

This article reports apical closure in two cases in which necrotic pulps were present and no endodontic treatment was performed prior to closure. Possible mechanisms for the occurrence are suggested.